Hum. Reprod. Advance Access published online on January 12, 2008
Human Reproduction, doi:10.1093/humrep/dem421
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GnRH agonist administration in the luteal phase in ICSI–ET cycles stimulated with the long GnRH agnosticprotocol: a randomized, controlled double blind study
Assisted Reproduction Unit, American Hospital of Istanbul, Guzelbahce Sokak No. 20, Nisantasi, Istanbul 34365, Turkey
1 Correspondence address. Tel: +90-212-3112000; Fax: +90-212-3112339; E-mail: barisata{at}hotmail.com
BACKGROUND: GnRH agonist administration in the luteal phase was reported to beneficially affect the clinical outcome of intracytoplasmic sperm injection (ICSI) and embryo transfer (ET) cycles. This double blind, randomized, placebo controlled trial evaluates whether a single dose GnRH agonist administered 6 days after ICSI increases ongoing pregnancy rates following ET in cycles stimulated with the long GnRH agonist protocol.
METHODS: Five hundred and seventy women undergoing ET following controlled ovarian stimulation with a long GnRH agonist protocol were included. In addition to routine luteal phase support with progesterone, women were randomized to receive a single 0.1 mg dose of triptorelin or placebo 6 days after ICSI. Randomization was done on the day of ET according to a computer generated randomization table. Ongoing pregnancy rate beyond 20th week of gestation was the primary outcome measure. The trial was powered to detect a 12% absolute increase from an assumed 38% ongoing pregnancy rate in the placebo group, with an alpha error level of 0.05 and a beta error level of 0.2.
RESULTS: There were 89 (31.2%) ongoing pregnancies in the GnRH agonist group, and 84 (29.5%) in the control group (absolute difference +1.7%, 95% confidence interval –5.8% to +9.2%). Implantation, clinical pregnancy and multiple pregnancy rates were likewise similar in the GnRH agonist and placebo groups.
CONCLUSIONS: Single 0.1 mg triptorelin administration 6 days after ICSI following ovarian stimulation with the long GnRH agonist protocol does not seem to result in an increase 
12% in ongoing pregnancy rates.
Clinicaltrials.gov Trials registration number NCT 00516490.
Key words: luteal phase support/GnRH agonist/intracytoplasmic sperm injection/ongoing pregnancy/implantation rate
Submitted on July 25, 2007; resubmitted on December 1, 2007; accepted on December 14, 2007.